Targets and Timescales: a study of dysphonia using objective assessment

Abstract

This study was established to look into objective measurement as a means of monitoring change within various diagnostic groups of dysphonic patients, using two hospital locations and comparing the results of clinical data from dysphonia assessments and re-assessments at approximately six-weekly intervals. The data was collated from the caseload of ten therapists with experience in the management of dysphonia. The study aimed to identify parameters of initial normality, those most disordered and those showing most improvement following therapeutic intervention. It also aimed to establish the use of objective measurements for targeting specific areas of therapy and to calculate average timescales of care and number of treatment sessions required for the different dysphonia groups.

The two centres, the Victoria Infirmary (VI) and Law Hospital (LH) NHS Trusts, operate similar Voice Assessment Clinic and Videostroboscopy procedures and are equipped with similar systems of computer-assisted instrumentation, i.e. ST1 airflow measurement, Visispeech and Electroglottography (EGG). A population sample was carried out in each centre to determine normative values for Visispeech and the EGG. The sample included 105 female and 68 male subjects.

The patient sample involved 68 patients in VI and 72 in LH and was grouped according to the laryngeal diagnosis as follows:- Vocal Strain (NAD), Vocal Nodules, Postsurgical, Ventricular Fold Overaction, Psychogenic, Bowed Vocal Folds, Post-Radiotherapy, Contact Ulcers and Vocal Fold Palsy. Patients were treated by therapists within their clinical workload, using their treatment of choice and determining the frequency, length and number of sessions according to their usual procedures. No therapy technique was prescribed and no time scale stated.

Objective assessments confirmed similar results between the two centres in that different diagnostic groups showed different parameters of initial normality, of disorder and improvement following therapeutic intervention, with consistent time scales and numbers of treatment sessions

Key Words:

• dysphonia
• objective
• parameter
• assessment